Okello Samson, Millard Alexander, Owori Rogers, Asiimwe Stephen Bambeiha, Siedner Mark Jacob, Rwebembera Joselyn, Wilson Laurence Anthony, Moore Christopher Charles, Annex Brian Herb
Department of Medicine, Mbarara University of Science and Technology, P,O Box 1410, Mbarara, Uganda.
BMC Cardiovasc Disord. 2014 Jun 10;14:75. doi: 10.1186/1471-2261-14-75.
Peripheral artery disease (PAD) is a major complication of atherosclerosis. PAD can be diagnosed with low-cost diagnostic techniques and is associated with significant morbidity and mortality. While the major epidemiologic risk factors for PAD have been established in the western world, data from resource-poor countries are limited. We performed a cross-sectional study to determine the prevalence and correlates of PAD among patients with diabetes at Mbarara Referral Hospital in southwestern Uganda.
We consecutively enrolled diabetes patients aged 50 years or greater presenting to the outpatient clinic. We collected blood for fasting lipid profile, HIV serology, and glycosylated hemoglobin, measured blood pressure and ankle brachial index, and administered the Edinburgh Claudication Questionnaire (ECQ). We also surveyed patients for other PAD risk factors. We used logistic regression to determine correlates of PAD.
We enrolled 229 diabetes patients. The median age of 60 years (IQR 55-66), and 146 (63.7%) were female. Fifty five patients (24%) had PAD (ABI of ≤ 0.9). Of these, 48 /55 (87.27%) had mild PAD (ABI 0.71-0.9) while 7/55 (12.73%) had moderate to severe PAD (ABI < 0.7). Amongst those with PAD, 24/55 (43.64%) reported claudication by the ECQ. Correlates of PAD included female sex (AOR 2.25, 95% CI 1.06 - 4.77, p = 0.034), current high blood pressure (AOR 2.59, 95% CI 1.25-5.33, p = 0.01), and being on a sulfonylurea-glibenclamide (AOR 3.47, 95% CI 1.55 - 7.76, p = 0.002).
PAD was common in diabetic patients in southwestern Uganda. Given its low cost and ease of measurement, ABI deserves further assessment as a screening tool for both PAD and long term cardiovascular risk amongst diabetics in this region.
外周动脉疾病（PAD）是动脉粥样硬化的主要并发症。PAD可用低成本诊断技术进行诊断，且与显著的发病率和死亡率相关。虽然PAD在西方世界的主要流行病学危险因素已得到确认，但资源匮乏国家的数据有限。我们开展了一项横断面研究，以确定乌干达西南部姆巴拉拉转诊医院糖尿病患者中PAD的患病率及其相关因素。
我们连续纳入了到门诊就诊的50岁及以上糖尿病患者。采集血液用于检测空腹血脂谱、HIV血清学和糖化血红蛋白，测量血压和踝臂指数，并进行爱丁堡跛行问卷（ECQ）评估。我们还调查了患者的其他PAD危险因素。我们使用逻辑回归分析来确定PAD的相关因素。
我们纳入了229例糖尿病患者。中位年龄为60岁（四分位间距55 - 66岁），146例（63.7%）为女性。55例患者（24%）患有PAD（踝臂指数≤0.9）。其中，48/55例（87.27%）患有轻度PAD（踝臂指数0.71 - 0.9），而7/55例（12.73%）患有中度至重度PAD（踝臂指数<0.7）。在患有PAD的患者中，24/55例（43.64%）通过ECQ报告有跛行症状。PAD的相关因素包括女性（比值比2.25，95%置信区间1.06 - 4.77，p = 0.034）、当前高血压（比值比2.59，95%置信区间1.25 - 5.33，p = 0.01）以及正在使用磺脲类药物格列本脲（比值比3.47，95%置信区间1.55 - 7.76，p = 0.002）。
在乌干达西南部，PAD在糖尿病患者中很常见。鉴于其成本低且易于测量，踝臂指数作为该地区糖尿病患者PAD和长期心血管风险的筛查工具值得进一步评估。
